超早期阶梯式康复训练在急性缺血性脑卒中围溶栓期应用效果观察  

Observation on the application effect of super-early laddering rehabilitation training in the patients with acute ischemic stroke during perithrombolytic period

作　　者：侯雪芬 金培英[1] 赵红艳[2] HOU Xuefen;JIN Peiying;ZHAO Hongyan(Emergency Room, Huzhou Central Hospital in Zhejiang Province, Huzhou 313000, China;Department of Neurology, Huzhou Central Hospital in Zhejiang Province, Huzhou 313000, China)

机构地区：[1]浙江省湖州市中心医院急诊抢救室,浙江湖州313000 [2]浙江省湖州市中心医院神经内科,浙江湖州313000

出　　处：《中国现代医生》2017年第31期78-81,85,共5页China Modern Doctor

基　　金：基金项目 浙江省湖州市科学技术局公益性技术研究B类(2016GYB60)

摘　　要：目的观察超早期阶梯式康复训练在急性缺血性脑卒中(AIS)围溶栓期应用效果。方法将80例AIS患者随机分为对照组和观察组,每组40例。溶栓后,对照组给予常规康复训练,观察组给予超早期阶梯式康复训练。分别于溶栓后24 h及溶栓后14 d检测患者血清神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)水平,行简易智能精神状态量表(MMSE)、简易上肢功能评价量表(STEF)、Fugl-Meyer运动功能量表(FMA)、改良Barthel指数量表(MBI)评分。结果溶栓后24 h,两组NGF、BDNF、NSE水平及STEF、FMA、MBI评分比较均无显著差异(P>0.05);溶栓后14 d,观察组较对照NGF、BDNF水平明显升高(P<0.05),NSE水平明显降低(P<0.05),MMSE、STEF、FMA、MBI评分均明显提高(P<0.05)。结论超早期康复训练可有效调节NGF、BDNF、NSE表达,加快脑组织重塑,促进AIS患者神经功能、认知功能、肢体运动功能、日常生活能力恢复。Objective To observe the application effect of super-early laddering rehabilitation training on acute ischemic stroke(AIS)during peri-thrombolytic period.Methods80patients with AIS were randomly divided into control group and observation group,with40cases in each group.After thrombolysis,the control group was given routine rehabilitation training,and the observation group was given super-early laddering rehabilitation training.Serum neurotrophic factor(NGF),neuron-specific enolase(NSE),brain-derived neurotrophic factor(BDNF)level,mini mental state examination scale(MMSE),simple upper limb function evaluation scale(STEF),Fugl-Meyer motor function scale(FMA),modified Barthel index scale(MBI)score were detected in the patients24h and14d after thrombolysis respectively.Results There were no significant differences in NGF,BDNF,NSE levels and STEF,FMA and MBI scores between the two groups after24hours of thrombolysis(P>0.05);on the14th day after thrombolysis,the levels of NGF and BDNF in the observation group were significantly higher than those in the control group(P<0.05).NSE level was significantly decreased(P<0.05).MMSE,STEF,FMA,MBI scores were significantly increased(P<0.05).Conclusion Super-early rehabilitation training can effectively regulate the expression of NGF,BDNF and NSE,speed up brain tissue remodeling,and promote neurological function,cognitive function,limb motor function,and daily life ability recovery in AIS patients.

关 键 词：急性缺血性脑卒中 围溶栓期 超早期阶梯式康复训练 神经功能损伤 

分 类 号：R743.2[医药卫生—神经病学与精神病学]